Introduction. Nigeria is one of 57 countries with critical shortage of health
workers (HWs). Strategies to increase and equitably distribute HWs are critical to the
achievement of Health Millennium/Sustainable Development Goals. We describe how three
Northern Nigeria states adapted World Health Organisation (WHO)-recommended incentives
to attract, recruit, and retain midwives. Methods. Secondary analysis of data from two
surveys assessing midwife motivation, retention, and attrition in Northern Nigeria; and
expert consultations. Results. Midwives highlighted financial and non-financial incentives as
key factors in their decisions to renew their contracts. Their perspectives informed the
consensus positions of health managers, policymakers and heads of institutions, and led to
the adaptation of the WHO recommendations into appropriate state-specific incentive
packages. Conclusions. The feedback from midwives combined with an expert consultation
approach allowed stakeholders to consider and use available evidence to select appropriate
incentive packages that offer the greatest potential for helping to address inadequate
numbers of rural midwives.